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Aims and objectives To understand hospice palliative care nurses' (HPCNs) perceptions towards spiritual care and their competence to provide spiritual care. Background Previous research has shown that many nurses lack a clear understanding of the concept of spirituality and feel inadequately prepared to assess patients' spiritual needs. Studies on competence in spiritual care are mostly descriptive, and the evidence for improving it is limited. Design A mixed-methods research design was used. Methods Quantitative data were collected from 282 nurses in forty hospice palliative care (HPC) institutions in South Korea and analysed using descriptive statistics, independent t-test, one-way ANOVA with Bonferroni test and multiple regression. Qualitative data collection involved two stages: first, an open-ended question posed to 282 nurses, and second, focus group interviews conducted with six HPC experts. Both qualitative data sets were analysed separately using content analysis. This study followed the GRAMMS guidelines. Results Of the six dimensions of spiritual care competence (SCC), the mean scores were highest in 'attitude towards the patient's spirituality' and 'communication', whereas the 'assessment and implementation of spiritual care' and 'professionalisation and improving the quality of spiritual care' had the lowest mean scores. Through content analysis, 4 themes regarding the meaning of spiritual care, 3 themes regarding requirements for spiritual care and 2 themes regarding preparedness for spiritual care were revealed. They perceived the needs of the understanding of spiritual care based on the attributes of spirituality, the education in systematic assessments and implementation for spiritual care with standardised terminology, and the opportunity to reflect on nurses' own spirituality. Conclusions Practical SCC training for HPCNs and the subsequent development of clinical practice guidelines are of vital importance. Relevance to clinical practice The results of this study provide a useful resource to develop educational programmes for strengthening the SCC of nurses and the entire HPC team.

Living with a terminal illness, whether as a patient or as the family member of a patient, often involves spiritual challenges. The ability to ascertain and meet the spiritual needs of terminally ill patients and their loved ones is an essential part of providing compassionate and competent whole person care. This study aimed to adapt the original Spiritual Interests Related to Illness Tool (SpIRIT) for use in Korea (SpIRIT-K) and to assess its reliability and validity as a tool to determine the spiritual needs of terminally ill Korean patients and their caregivers. After translation-back-translation and content validity indexing, SpIRIT-K was administered to 106 terminally ill patients and 105 family caregivers in 20 sites across South Korea. SPSS and AMOS were used for evaluating validity and reliability. The 37-item SpIRIT-K consisted of 8 factors (subscales), with each subscale consisting of between 3 and 8 items. Evidence for structural and convergent validity was observed. Internal reliability of the overall scale was 0.95. The findings showed patients and family caregivers reported no significant difference in 7 of the 8 subscales, demonstrating known-groups validity. The rigorous process of establishing cross-cultural validity for this scale provided evidence supporting its validity and reliability. The findings suggest that SpIRIT-K is suitable for research and for clinical purposes in palliative care settings in South Korea. This development also allows for comparisons between Korean and North American cultures in terms of spiritual needs among terminally ill patients and their caregivers.

This study aimed to compare perceptions of spiritual care among patients with life-threatening cancer, their primary family caregivers, and hospice/palliative care nurses.Data were collected using both structured and unstructured approaches. Structured questionnaire data were examined using statistical analysis methods, and unstructured data were examined using content analysis to compare the 3 participant groups. The questionnaire revealed that among all 3 groups, spiritual care was commonly perceived to relate to "having the opportunity for internal reflection," "finding meaning," "encouraging hope," and "listening to and being with patients." Content analysis of the unstructured data revealed 5 themes: "Caring with sincerity," "Strengthening spiritual resources," "Alleviating physical pain and discomfort" (among patients and primary family caregivers only), "Improving spiritual care service," and "Multifaceted cooperation" (among hospice/palliative care nurses only). Our findings suggest that for patients with life-threatening illnesses such as terminal cancer, spiritual care should not be limited to religious practice but should also satisfy inner existential needs, for example, by encouraging hope, providing empathy, and helping patients find meaning in their circumstances.

The aim of this study was to compare the learning effects of debriefing methods used in the simulation of prematurity care by measuring: (i) academic self-efficacy; (ii) confidence in performance; (iii) self-assessed communication skills; and (iv) satisfaction. We employed a quasi-experimental design with three experimental groups that experienced instructor-directed, self-directed, and video-assisted, self-directed debriefing, respectively. Participants were 146 senior nursing students from three nursing schools. To compare learning effects, the same developed scenario for prematurity care was applied to all three groups. Significant differences were observed in the mean scores for the study variables among the three groups. The post-hoc analysis showed that the video-assisted, self-directed debriefing group obtained the highest mean score difference for confidence in performance, self-assessed communication skills, and satisfaction with the debriefing method. Thus, video-assisted, self-directed debriefing could be the most effective debriefing method for students.

This study aimed to examine the reliability and validity of a scale to assess the competence of Korean nurses who provide spiritual care for patients with terminal illnesses. The reliability and validity were examined using Cronbach α, item analysis, and exploratory factor analysis. The participants were 248 hospice nurses working at 40 hospices and palliative hospitals in South Korea. The results showed that the reliability was high, as indicated by a Cronbach α of .942. The exploratory factor analysis revealed 6 dimensions (assessment and implementation of spiritual care, professionalization and improvement of the quality of spiritual care, personal support and patient counseling, referral to professionals, attitude toward the patient's spirituality, and communication) with 27 items. The 6 factors explained 68.20% of the variance in the Korean version of the Spiritual Care Competence Scale. From the results, the Korean version of the Spiritual Care Competence Scale may serve as an appropriate measure for provision of spiritual care for patients with terminal illness. In addition, it may be useful in assessing hospice and palliative nurses' ability for spiritual care.

Aim: To develop flipped learning classes by using film clips for undergraduate nursing students in an online nursing informatics course, based on the Analysis, Design, Development, Implementation, and Evaluation model, and to evaluate the effectiveness and students’ responses to this method of teaching. Methods: Sixty-four second-year nursing students participated in the course. The nursing students’ knowledge was assessed at the beginning and end of each of the five classes. Moreover, their intention to recommend the classes to other students and additional comments were elicited by using semistructured questionnaires. Results: Knowledge about each core concept of nursing informatics reflected significant improvement. Regarding the intention to recommend the class to others, 62 (96.8%) students answered “strongly recommend” or “recommend.” Conclusion: Integrating flipped learning classes by using film clips in an online nursing informatics course improved the nursing students’ knowledge and is a format that is desired by students.

Background Spirituality is a fundamental, intrinsic aspect of human beings and should be a core component of quality palliative care. There is an urgent need to train hospice palliative care teams (HPCTs) to enhance their ability to provide spiritual care. This study aimed to develop and evaluate a meaning-centered, spiritual care training program (McSCTP) for HPCTs (McSCTP-HPCTs). Methods The modules’ content was informed by Viktor Frankl’s meaning-centered logotherapy with its emphasis on spiritual resources, as well as the spiritual care model of the Interprofessional Spiritual Care Education Curriculum (ISPEC). Following development, we conducted a pilot test with four nurses. We used the results to inform the final program, which we tested in an intervention involving 13 members of HPCTs. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis test, we analyzed the participants’ demographic and career-related characteristics, as well as the degree of variance between three outcome variables: compassion fatigue (CF), spiritual care competencies (SCCs), and spiritual care therapeutics (SCT). Results We divided the McSCTP-HPCTs into five modules. Module I: The HPCTs’ SCC evaluation, understanding the major concepts of spiritual care and logotherapy; Modules II-IV: Meaning-centered interventions (MCIs) related to spiritual needs (existential, relational, and transcendental/religious); Module V: The process of meaning-centered spiritual care. The preliminary evaluation revealed significant differences in all three outcome variables at the posttest point (CF, p = 0.037; SCCs, p = 0.005; SCT, p = 0.002). At the four-week follow-up test point, we only found statistical significance with the SCCs (p = 0.006). Conclusions The McSCTP-HPCTs is suitable for use in clinical settings and provides evidence for assessing the SCCs of HPCTs.

With the global pandemic of the coronavirus disease, virtual reality simulation (vSim) has emerged as a simulation educational method. The purpose of this study is to examine the learning effects of vSim by comparing three different educational modalities of nursing care for children with asthma. A quasi-experimental design with three different teaching methods, vSim, high-fidelity simulation (HFS), and vSim with HFS, were used in the study. The group using vSim with HFS showed the highest scores in knowledge, confidence in practice, and performance compared to groups using vSim or HFS alone. Simulation practice using vSim combined with HFS could be an effective educational method for nursing students.

Background Online misinformation proliferation during the COVID-19 pandemic has become a major public health concern. Objective We aimed to assess the prevalence of COVID-19 misinformation exposure and beliefs, associated factors including psychological distress with misinformation exposure, and the associations between COVID-19 knowledge and number of preventive behaviors. Methods A cross-sectional online survey was conducted with 1049 South Korean adults in April 2020. Respondents were asked about receiving COVID-19 misinformation using 12 items identified by the World Health Organization. Logistic regression was used to compute adjusted odds ratios (aORs) for the association of receiving misinformation with sociodemographic characteristics, source of information, COVID-19 misinformation belief, and psychological distress, as well as the associations of COVID-19 misinformation belief with COVID-19 knowledge and the number of COVID-19 preventive behaviors among those who received the misinformation. All data were weighted according to the Korea census data in 2018. Results Overall, 67.78% (n=711) of respondents reported exposure to at least one COVID-19 misinformation item. Misinformation exposure was associated with younger age, higher education levels, and lower income. Sources of information associated with misinformation exposure were social networking services (aOR 1.67, 95% CI 1.20-2.32) and instant messaging (aOR 1.79, 1.27-2.51). Misinformation exposure was also associated with psychological distress including anxiety (aOR 1.80, 1.24-2.61), depressive (aOR 1.47, 1.09-2.00), and posttraumatic stress disorder symptoms (aOR 1.97, 1.42-2.73), as well as misinformation belief (aOR 7.33, 5.17-10.38). Misinformation belief was associated with poorer COVID-19 knowledge (high: aOR 0.62, 0.45-0.84) and fewer preventive behaviors (≥7 behaviors: aOR 0.54, 0.39-0.74). Conclusions COVID-19 misinformation exposure was associated with misinformation belief, while misinformation belief was associated with fewer preventive behaviors. Given the potential of misinformation to undermine global efforts in COVID-19 disease control, up-to-date public health strategies are required to counter the proliferation of misinformation.

Purpose: This study analyzes meaning-centered intervention studies conducted in Korea and abroad to compare and confirm their characteristics and results. Methods: A literature search using keywords in English and Korean was performed using nine electronic databases in December 2017. Search participants included adolescents, and interventions conducted in meaning-centered intervention studies were selected for evaluation. A Risk of Bias Assessment tool for non-randomized studies was used for quality assessment. Results: All studies were based on quasi-experimental designs. The semantic intervention included topics such as freedom, choice, responsibility, pain, death, finding value of life, purpose and meaning of life, and becoming a master of my life. All studies used logotherapy, and included meaningful interventions that influenced the meaning and purpose of the life of adolescents. The life satisfaction of adolescents changed significantly when there is a positive and open relationship with their parents. Therefore, an educational program for parents based on meaning therapy is desperately needed. Conclusion: Meaning-centered interventions were found to be effective interventions for exploring the meaning of life not only for adolescents with problems but also for healthy youth, and as such could be used as basic data for the development of an appropriate intervention for enhancing their life.

Purpose: The purpose of this study was to explore nursing students’ experiences of debriefing after simulation-based learning and to obtain fundamental data to support the development of effective teaching strategies. Methods: Sixty-seven nursing students participated in this study from April to May, 2017. This was a descriptive study analyzing the content of students’ descriptions of structured questions in 3 stages (description, analysis, and application) based on recorded videos. Results: The description stage was classified into 3 categories for problem recognition, 4 categories for the nursing plan, and 6 categories for the nursing intervention. The analysis stage was classified into 6 categories for satisfactory practice, 3 categories for experience and 4 categories for what they learned through practice. The application stage was classified into 5 categories, that were to be mastered, and 6 categories, that were important to recognize. Conclusion: This study succeeded in charaterizing learners’ experiences of debriefing. During the debriefing, students watched recorded videos, and we found that self-evaluation through structured questionnaires could be a very effective way to strengthen students’ core competencies. Our content analysis of the debriefing is expected to contribute to the development of effective strategies in simulation-based education for students and nurses.

In this study, we identified the factors influencing behavioral intention to undergo Papanicolaou testing among Japanese and Korean women in early adulthood. Their behavioral intentions were compared in this cross-sectional descriptive study. In total, 887 women (Japanese = 498, Korean = 389) aged 20-39 years participated in this study. Using a self-report questionnaire, knowledge, attitudes, subjective norm, perceived behavioral control, and behavioral intention were surveyed. There were significant differences between Japanese and Korean women's scores on all main variables. For Japanese women, all the variables moderately correlated with behavioral intention. In comparison, for Korean women, all independent variables, except for knowledge, moderately correlated with behavioral intention. Through a multiple regression analysis, age, undergoing Papanicolaou testing, attitudes, subjective norm, and perceived behavioral control were identified as significant predictors of behavioral intention among Japanese women. Among Korean women, job status, undergoing a Papanicolaou test, attitudes, subjective norm, and perceived behavioral control were demonstrated as significant predictors of behavioral intention. Health professionals should consider these factors to encourage Papanicolaou testing in women in early adulthood.

Purpose: The purpose of this study was to set up a hypothetical model to explain causal relationships among influential variables in the mother-child relationship for Korean infants and toddlers and their mothers. The research was based on Barnard’s (1978) mother-child relations model, and goodness-of-fit was examined. Methods: The participants were 207 mothers with infants or toddlers. Data were analyzed using SPSS and AMOS programs. Results: Regarding the influence of the variables on the mother-child relationship between infants and toddlers and their mothers, social support had a 75% explanation of mother-child relationships, and attachment had a 58% explanation of social support. Attachment had both direct and indirect effects on the mother-child relationships, and social support had direct and total effects on the mother-child relationships. Among child-related variables, child temperament had a moderating effect on the mother-child relationships. Conclusion: The findings indicate that the model has utility in developing effective nursing intervention methods to boost mother-child relationships between infants and toddlers and their mothers.

Educational outcomes, such as knowledge, confidence in performance, ability in nursing practice, and satisfaction with learning methods in caring for children with croup, were compared between groups of students that received education through simulation combined with pre-education, simulation only, and pre-education only. In this quasi-experimental design, the educational intervention for the experimental group was the pre-education modality. Data from a convenience sample of 127 senior nursing students were drawn from three nursing schools in South Korea. There were significant differences in the mean scores of knowledge, confidence in performance, satisfaction with the learning method, and ability in nursing practice between the three groups. Pre-education with simulation significantly enhanced students' knowledge, confidence in performance, ability in nursing practice, and satisfaction with learning methods compared with pre-education or simulation alone. Simulation strategies should focus more on enhancing nursing students' learning outcomes.

Purpose: The purpose of this study was to explore the experience of the meaning in life for elementary school students. Methods: The conceptual framework was based on the five main concepts (meaning in life, creativity, experiences, attitudes, choice and responsibility) of logotherapy. Data from 1,600 higher grade elementary school students were analyzed for content of meaning in life. Results: The experiences of meaning in life were identified as follows: Important things in my life (people close to me, things that brings me happiness, to live in earnest, surrounding environment), Activities I like to do (relaxing, achievements, family relationships), Experiences that made me feel like I am loved (taken care of by family, material recompense, being respected), Times when I feel grateful (receive love and care, health), Importance of choices (consequences of bad choices, result of good life choices). Conclusion: These Results suggest that elementary school students can understand meaning-centered health education and this kind of education is necessary to promote their wholistic health.

The purpose of this study was to identify the differences in suicide risk, meaning in life, and need for life respect among three age groups (young adults, the middle aged, and the elderly) of 540 public hospital outpatients in South Korea. This was a cross-sectional study. Among these 3 age groups, we observed significant differences in suicide risk, meaning in life, and need for life respect according to education level, marital status, living arrangements, type of disease, gender, and monthly income. These findings might contribute to the prevention of suicide in the future and the implementation of better community-based nursing care.

To promote the growth and development of premature infants, effective and tender care is required in neonatal intensive care units (NICUs). The purpose of this study was to test the potential effects of massage therapy on increasing physical growth and promoting gastrointestinal function in premature infants. Twenty subjects were divided into two groups in the NICU of one general hospital located in South Korea. The experimental group ( n = 10) were given massage therapy and the control group ( n = 10) received routine care. Massage therapy was performed twice daily for 14 days, for 15 minutes per session. In the physical growth, height and chest circumference were significantly increased in the experimental group. In assessing gastrointestinal function, frequency of pre-feed gastric residual was significantly decreased and numbers of bowel movements were significantly increased in the experimental group. This study showed massage therapy has the potential effects on increasing physical growth and gastrointestinal function in premature infants. The massage in the NICU might be utilized as a part of developmental care, but more research needs to be done. NICU nurses need to be trained in massage therapy techniques to provide more effective clinical care for premature infants.

Purpose: This study was done to provide basic data for sexual abuse prevention programs for elementary school students by comparing stated needs of the students and teachers. Methods: The participants were 4th, 5th, and 6th grade elementary school students and elementary school teachers. Data from questionnaires completed by 1,372 students and 162 teachers were analyzed. Results: 1) The mean scores for felt need for sexual abuse prevention education was relatively high in both of the elementary school student and teacher groups but there was a significant difference between the two groups (t = 15.28, p < .001). 2) In the elementary school students, there was a significant difference in the degree of need for sexual abuse prevention education according to father’s educational level (t = 2.89, p = .004), experience of sexual education (t = 3.11, p = .006), and recognition of the necessity of sexual abuse education (t = 7.56, p < .001). 3) In the elementary school teachers, there was no significant difference in the degree of need for sexual abuse prevention education according to the participants’ socio-demographic and sexual abuse prevention education related characteristics. Conclusion: When planning educational programs on child sexual abuse prevention, needs of the elementary school students should be considered. Then, the educational program at school would be more effective.

Aim The purpose of this study was to develop an educational program to promote healthy life behaviors and to evaluate its potential effects on the health practices of fifth grade elementary school children. Methods The program, which consisted of six categories (daily life and health, disease prevention and management, prevention of drug misuse and overuse, sexuality and health, mental health, and injury prevention and first aid), was developed based on the ADDIE model. A pretest–post-test, one-group, quasi-experimental design was used with 85 elementary school students who voluntarily participated in the program. Results A school-based educational program, called the “Six Kid Keys,” referring to the six categories of healthy life behaviors, was developed. Significant pre–post differences in two of the six healthy life behavior categories (disease prevention and management, injury prevention and first aid) were found. Conclusion A school-based intervention that was aimed at changing habits related to healthy life behaviors could be effective for elementary school children.

Summary Background The lack of reliable and valid tools to evaluate learning outcomes during simulations has limited the adoption and progress of simulation-based nursing education. Purposes This study had two aims: (a) to develop a simulation evaluation tool (SET c-dehydration ) to assess students' clinical judgment in caring for children with dehydration based on the Lasater Clinical Judgment Rubric (LCJR) and (b) to examine its reliability and validity. Participants Undergraduate nursing students from two nursing schools in South Korea participated in this study from March 3 through June 10, 2014. Methods The SET c-dehydration was developed, and 120 nursing students' clinical judgment was evaluated. Descriptive statistics, Cronbach's alpha, Cohen's kappa coefficient, and confirmatory factor analysis (CFA) were used to analyze the data. Results A 41-item version of the SET c-dehydration with three subscales was developed. Cohen's kappa (measuring inter-observer reliability) of the sessions ranged from .73 to .95, and Cronbach's alpha was .87. The mean total rating of the SET c-dehydration by the instructors was 1.92 (±.25), and the mean scores for the four LCJR dimensions of clinical judgment were as follows: noticing (1.74±.27), interpreting (1.85±.43), responding (2.17±.32), and reflecting (1.79±.35). CFA, which was performed to test construct validity, showed that the four dimensions of the SET c-dehydration was an appropriate framework. Conclusion The SET c-dehydration provides a means to evaluate clinical judgment in simulation education. Its reliability and validity should be examined further.

BACKGROUND For patients with advanced or terminal cancer undergoing hospice or palliative care, spiritual care based on meaning-centered intervention (MCI) has become an essential form of support. OBJECTIVE The aim of this study was to characterize MCI systematically and the effectiveness of hospice and palliative care for patients with advanced or terminal cancer. METHODS MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean electronic databases were searched from inception to May 2017. The RevMan 5.3 program of the Cochrane Library was used for data analysis. RESULTS A meta-analysis was conducted of 10 controlled trials (6 randomized and 4 nonrandomized) featuring 623 patients with cancer. Meaning-centered interventions were compared with usual care control groups or other psychosocial interventions. The weighted average effect sizes across studies were -0.96 (P < .001, I = 7%) for meaning in life, -0.37 (P = .002, I = 0%) for spiritual well-being, -0.48 (P < .001, I = 0%) for quality of life, -0.28 (P = .02, I = 0%) for anxiety, and -0.31 (P = .02, I = 17%) for physical symptoms. CONCLUSION Spiritual care based on MCI may help to improve the physical, psychosocial, and spiritual well-being of patients with advanced or terminal cancer. IMPLICATION FOR PRACTICE Meaning-centered interventions could be a valuable way to enhance quality of life at the end stage for patients with advanced or terminal cancer.

This study determines the effect of simulation with team-based learning (TBL) on newborn nursing care. This randomized controlled trial included 74 nursing students from one university located in Seoul, South Korea. Participants were categorized into two groups according to educational modality: one group involved both simulation and TBL, and the other involved simulation alone. Learning attitudes, academic achievement, and simulation performance were examined to assess effectiveness. The mean difference in learning attitudes between the two groups was non-significant. Low academic achievement differed significantly between the two groups (t = 3.445, P = 0.002). There was no significant difference in mean scores for simulation performance between the two groups. In this study, simulation with TBL was effective in improving learning outcomes. In current nursing education, various learning methods are employed within complex nursing situations and require flexibility and problem-solving approaches.

The purpose of this study was to develop a smartphone-based injury-prevention application (S-IPA) for teachers working in child-care centers, and to test the satisfaction level of the users of the application (app). Through a literature review and needs assessment, an app compatible with the Apple iPhone operating system was developed. The app was verified and the mean total satisfaction with 7 features of the app was 7.76 (± 1.13) on a score of 1-10. The result of the S-IPA survey showed a positive response, indicating a high potential for use as a teacher's educational guide, which would provide an effective information delivery system for the prevention of possible injuries at child-care centers.

본 연구는 진행성 및 말기 암 환자를 대상으로 의미중심 중재를 적용한 국내외 연구를 분석하고 평가함으로써 간호실무 및 연구분야에 의미중심 중재의 적용을 위한 근거자료를 제시하기 위해 시도되었다. 질적 연구와 양적 연구 등 모든 연구설계를 포함하여 평가하는 Whittemore와 Knafl17)의 통합적 고찰방법을 적용하여 국내외 의미중심 중재 관련논문을 검색하였다. 2017년 7월부터 8월까지 국외 4개의 databases (PubMed, MEDLINE, EMBASE, Cochrane, and CINAHL), 국내 5개의 databases (KMbase, RISS, Nanet, KISS, and NDSL)를 검색하였고, 검색은 개별 전자DB에서 자료를 제공하는 년도부터 2017년 8월까지 출판된 자료로 하였다. 데이터베이스를 통해서 검색된 초기 문헌은 국외 총 8,537편, 국내 총 2,202편이 검색되었다. 중복검사 및 선정기준에 부합한 논문 선별을 통해 최종 17편의 국내외 문헌이 선정되었다. 실험연구 13편에 대해서는 RoB과 RoBANS를 활용하여 각 논문의 질을 평가하였다. 총 17편에서 무작위 실험연구 8편, 유사 실험연구가 5편, 서술연구 3편, 고찰연구 1편이었다. RoB과 RoBANS로 평가된 13편의 연구가 대부분의 영역에서 비뚤림 위험이 낮았으며, 주로 그룹중재, 8회기, 1 회기당 시간은 90분 또는 120분이 가장 많았고, 결과변수로 삶의 질, 불안, 우울, 삶의 의미, 영적안녕 등이 다수의 연구에서 사용되었다. 의미중심 중재내용구성을 보면, 중재의 목적은 암 진단 상황에서도 삶의 의미를 발견함으로써 삶의 안녕감을 증진하고자 하는 것이었으며, 회기별 중재에서 다루어진 공통된 의미요법의 개념들은 인간존재의 본질적 특성(삶의 의미, 의미추구의 의지, 의지의 자유, 선택과책임, 자아초월적 특성, 유머)과 의미발견의 방법으로 3가지 가치(창조성, 경험, 태도)이었다. 사용 교육방법은 강의 및 토론, 적용 및 그룹토의, 독서 및 자아성찰을 통한 개별과제를 적용하였다. 다른 질병에 비해 죽음을 더 가까이 인지하게 되는 진행성 및 말기 암은 암 환자와 가족이 실존의 본질에 대한 관심과 높은 영적 요구를 갖게 되는 계기가 된다. 따라서 암 환자와 가족의 영적요구에 맞는 표준화된 영적 돌봄으로서 의미중심 중재 적용의 당위성에 대한 근거자료가 본 연구를 통해 확인되었다고 본다.